Gruszecka Jolanta, Filip Rafał
Institute of Health Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland.
Department of Clinical Microbiology, Clinical Hospital No. 2, 35-301 Rzeszow, Poland.
Microorganisms. 2024 May 17;12(5):1008. doi: 10.3390/microorganisms12051008.
Spontaneous Bacterial Peritonitis (SBP) is a serious complication and a common cause of death in patients with liver cirrhosis. Between January 2017 and March 2024, a retrospective study was conducted involving 302 patients (>18 years old) with ascites treated at a tertiary referral center in south-eastern Poland. Microbiological analysis of the ascitic fluids was performed in all patients. The presence of microorganisms was found in samples from 17 patients, and 21 pathogens were isolated, including 15 Gram-positive bacteria and 6 Gram-negative bacteria. , MRCNS (methicillin-resistant coagulase-negative staphylococci, resistant to all beta-lactam antibiotics: penicillins, penicillins with beta-lactamase inhibitor, cephalosporins and carbapenems) was the main pathogen detected (19.05%, 4/21), followed by (9.52%, 2/21), (9.52%, 2/21), , MRCNS (4.76%, 1/21), (9.52%, 2/21), (9.52%, 2/21), (4.76%, 1/21) and spp. (4.76%, 1/21). The following Gram-negative bacteria were also found in the specimens examined: , ESBL (extended-spectrum β-lactamase producing ) (4.76%, 1/21), (4.76%, 1/21), (4.76%, 1/21), (9.52%, 2/21) and (4.76%, 1/21). Gram-positive bacteria caused nosocomial infections in nine patients with SBP, Gram-negative bacteria caused nosocomial infections in two patients. In six patients with SBP, community-acquired infections caused by Gram-negative bacteria were found in three cases, Gram-positive bacteria in two cases, and in one case, community-acquired infection was caused by mixed Gram-positive and Gram-negative. Bacteria isolated from patients with hospital-acquired SBP showed higher drug resistance than those found in patients with non-hospital SBP. Bacterial infections in cirrhotic patients with complications may be responsible for their deteriorating health. Prompt intervention is critical to reducing mortality.
自发性细菌性腹膜炎(SBP)是肝硬化患者的一种严重并发症和常见死因。2017年1月至2024年3月,在波兰东南部一家三级转诊中心对302例(年龄>18岁)腹水患者进行了一项回顾性研究。对所有患者的腹水进行了微生物学分析。在17例患者的样本中发现了微生物,分离出21种病原体,包括15种革兰氏阳性菌和6种革兰氏阴性菌。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS,对所有β-内酰胺类抗生素耐药:青霉素、含β-内酰胺酶抑制剂的青霉素、头孢菌素和碳青霉烯类)是检测到的主要病原体(19.05%,4/21),其次是[具体细菌名称1](9.52%,2/21)、[具体细菌名称2](9.52%,2/21)、[具体细菌名称3]、MRCNS(4.76%,1/21)、[具体细菌名称4](9.52%,2/21)、[具体细菌名称5](9.52%,2/21)、[具体细菌名称6](4.76%,1/21)和[具体细菌名称7]属(4.76%,1/21)。在所检查的标本中还发现了以下革兰氏阴性菌:[具体细菌名称8]、产超广谱β-内酰胺酶(ESBL)的[具体细菌名称9](4.76%,1/21)、[具体细菌名称10](4.76%,1/21)、[具体细菌名称11](4.76%,1/21)、[具体细菌名称12](9.52%,2/21)和[具体细菌名称13](4.76%,1/21)。革兰氏阳性菌在9例SBP患者中引起医院感染,革兰氏阴性菌在2例患者中引起医院感染。在6例SBP患者中,3例由革兰氏阴性菌引起社区获得性感染,2例由革兰氏阳性菌引起,1例由革兰氏阳性菌和革兰氏阴性菌混合引起社区获得性感染。医院获得性SBP患者分离出的细菌比非医院SBP患者分离出的细菌显示出更高的耐药性。肝硬化并发感染的患者,其健康状况恶化可能与此有关。及时干预对于降低死亡率至关重要。